| NPI | 1255816591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018035915) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2011034040) |
| 207Q00000X Family Medicine (Licence: MO 2018035915) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81402-052) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2018035915) | |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2023-11-20 |